Disease activity, and disease extent and fecal incontinence among Japanese patients with ulcerative colitis: a cross-sectional study

Abstract

Abstract Background Fecal incontinence (FI) reduces patients’ quality of life. However, evidence regarding FI in patients with ulcerative colitis (UC) is limited. In previous studies of patients with UC, disease activity is positively associated with FI. On the other hand, the association between the disease extent and FI remains inconsistent. Therefore, we examined disease activity, disease extent, and a combination of disease activity and disease extent, and FI in Japanese patients with UC. Methods This study included 290 Japanese UC patients. FI and severe FI were defined on the basis of the frequency of incontinence. The disease extent was divided into total colitis, left-sided colitis, proctitis, and others. Complete mucosal healing (CMH) and mucosal healing (MH) were defined as Mayo endoscopic subscores of 0 and 1, respectively. Information on clinical remission (CR) was collected from the medical records. Results The rates of male sex, CMH, MH, CR, FI, and severe FI were 57.6%, 25.2%, 61.0%, 59.3%, 13.8%, and 5.9%, respectively. CMH, MH, and CR were independently inversely associated with FI and severe FI, respectively. No association was found between the disease extent and FI, and severe FI. Total colitis active stage UC was independently and positively associated with FI and severe FI (adjusted OR 2.51 [95% CI 1.22–5.18], and adjusted OR 3.95 [95% CI 1.38–11.85]). Other disease extents were not associated with FI or severe FI, regardless of active stage. Conclusions In Japanese patients with UC, disease activity was independently inversely associated with FI and severe FI. The total colitis with active stage was significantly positively associated with FI and severe FI. Other disease extents were not associated with FI, regardless of disease activity. Trial registration This study is also registered UMIN (000051334).